- Keywords
- Keytruda, pembrolizumab,
- MeSH
- Antibodies, Monoclonal, Humanized * pharmacology adverse effects therapeutic use MeSH
- Immunotherapy * adverse effects MeSH
- Humans MeSH
- Melanoma * drug therapy MeSH
- Neoplasm Metastasis drug therapy MeSH
- Drug-Related Side Effects and Adverse Reactions * drug therapy therapy MeSH
- Disease-Free Survival MeSH
- Antineoplastic Agents * pharmacology adverse effects therapeutic use MeSH
- Randomized Controlled Trials as Topic MeSH
- Drug Approval MeSH
- Check Tag
- Humans MeSH
- Keywords
- pembrolizumab, Keytruda, studie KEYNOTE-522, studie KEYNOTE-355,
- MeSH
- Programmed Cell Death 1 Receptor analysis MeSH
- Clinical Studies as Topic MeSH
- Clinical Trials, Phase III as Topic MeSH
- Combined Antibody Therapeutics * pharmacology therapeutic use MeSH
- Humans MeSH
- Antineoplastic Agents pharmacology therapeutic use MeSH
- Gene Expression Profiling methods MeSH
- Triple Negative Breast Neoplasms * diagnosis drug therapy pathology MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Overall MeSH
- MeSH
- Survival Analysis MeSH
- Programmed Cell Death 1 Receptor antagonists & inhibitors MeSH
- Antibodies, Monoclonal, Humanized administration & dosage MeSH
- Neoplasm Invasiveness pathology MeSH
- Humans MeSH
- Carcinoma, Non-Small-Cell Lung * drug therapy pathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- News MeSH
- Keywords
- Keytruda,
- MeSH
- Antibodies, Monoclonal, Humanized administration & dosage adverse effects MeSH
- Immunotherapy MeSH
- Ipilimumab administration & dosage adverse effects MeSH
- Humans MeSH
- Melanoma * drug therapy MeSH
- Disease Progression MeSH
- Aged MeSH
- Neoplasm Grading MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
Uveální melanom je nejčastější formou okulárního melanomu. Onemocnění bývá sice většinou zachyceno v lokalizovaném stadiu, ale v 50 % případů metastazuje, dominantně do jater a jeho prognóza je velmi nepříznivá. Metastatické onemocnění je většinou disseminované a neřešitelné operačně nebo jinými lokoregionálními postupy. Z toho vyplývá potřeba hledání účinné systémové terapie pro metastatický uveální melanom. Léčebné možnosti jsou ale velmi omezené. Jak chemoterapie, tak i moderní preparáty typu imunoterapeutik a antiBRAF/MEK terapie, které máme k dispozici k systémové léčbě metastatického maligního melanomu, mají u uveálního melanomu omezenou efektivitu. Jsou ale popsány ojedinělé případy léčebných odpovědí na léčbu anti-PD-1 protilátkami, zejména pembrolizumabem. V tomto sdělení prezentujeme výsledky našeho souboru čtyř pacientů s metastatickým maligním melanomem okulárního původu, kteří byli léčeni anti-PD-1 protilátkami.
Uveal melanoma is the most common form of ocular melanoma. The disease is usually detected when in a localized stage; in 50% of cases, however, it metastasizes, predominantly into the liver, and the prognosis is very unfavourable. Metastatic disease tends to be disseminated and is not manageable with surgery or other locoregional therapies. As a result, there is a need for finding an effective systemic treatment for metastatic uveal melanoma. The treatment options are, however, very limited. Both chemotherapy and modern agents, such as immunotherapeutic drugs and antiBRAF/MEK therapy that are available for systemic treatment of metastatic malignant melanoma, have limited efficacy in uveal melanoma. Nevertheless, isolated cases of therapeutic responses to treatment with anti-PD-1 antibodies, particularly with pembrolizumab, have been described. This paper presents the outcomes in our cohort of four patients with metastatic malignant melanoma of ocular origin who were treated with anti-PD-1 antibodies.
- Keywords
- Keytruda,
- MeSH
- Antibodies, Monoclonal, Humanized administration & dosage therapeutic use MeSH
- Middle Aged MeSH
- Melanoma * drug therapy pathology MeSH
- Neoplasm Metastasis * MeSH
- Uveal Neoplasms * drug therapy pathology MeSH
- Nivolumab administration & dosage therapeutic use MeSH
- Disease Progression MeSH
- Antineoplastic Agents, Immunological administration & dosage therapeutic use MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
- Keywords
- KEYTRUDA (pembrolizumab),
- MeSH
- Antibodies, Monoclonal, Humanized administration & dosage MeSH
- Middle Aged MeSH
- Humans MeSH
- Carcinoma, Non-Small-Cell Lung * diagnostic imaging drug therapy pathology MeSH
- Gene Expression Regulation, Neoplastic drug effects MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
Imunoterapie je slibnou léčebnou metodou, která si rychle získala své místo v léčbě mnoha malignit. Předpoklad jejího účinku u nádorů hlavy a krku vychází z vysoké mutační zátěže těchto nádorů. Klinické studie fáze I byly v souladu s preklinickými předpoklady. Následné studie fáze II a III potvrdily účinnost inhibitorů kontrolních bodů nivolumabu (OPDIVO) v druhé linii paliativní léčby a v případě pembrolizumabu v první linii léčby recidivujícího a metastazujícího karcinomu hlavy a krku. V České republice bylo použití pemobrolizumabu schváleno v roce 2014. V jasně definovaných indikacích je nyní léčba pembrolizumabem (Keytruda) hrazena i z veřejného zdravotního pojištění. V České republice však stále zůstává zlatým standardem v první linii léčby karcinomu hlavy a krku chirurgická léčba následovaná adjuvantní onkologickou léčbou. Nicméně přístup je vždy individuální a nejlepší léčebná modalita se volí na základě rozsahu primárního onemocnění a celkového stavu a preferencí pacienta.
Immunotherapy is a promising therapeutic modality that has rapidly gained its place in the treatment of many malignancies. The assumption of its effect in head and neck tumors stems from the high mutational load of these tumors. Phase I clinical trials were consistent with preclinical assumptions. Subsequent phase II and III trials confirmed the efficacy of the check-point inhibitors nivolumab (OPDIVO) in second-line palliation, and in the case of pembrolizumab, in first-line treatment of recurrent and metastatic head and neck cancer. In the Czech Republic, the use of pemobrolizumab was approved in 2014. In clearly defined indications, pembrolizumab therapy (Keytruda) is now also covered by public health insurance. However, in the Czech Republic, surgical treatment followed by adjuvant oncological treatment still remains the gold standard in the first-line treatment of head and neck cancer. Nevertheless, the approach is always individual and the best treatment modality is chosen based on the extent of the primary disease and the overall condition and preferences of the patient.
- MeSH
- Antibodies, Monoclonal, Humanized pharmacology adverse effects therapeutic use MeSH
- Immunotherapy * methods adverse effects trends MeSH
- Immune Checkpoint Inhibitors pharmacology adverse effects therapeutic use MeSH
- Clinical Studies as Topic MeSH
- Humans MeSH
- Head and Neck Neoplasms * epidemiology drug therapy therapy MeSH
- Nivolumab pharmacology adverse effects therapeutic use MeSH
- Antineoplastic Agents, Immunological pharmacology adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
